Basic Information
Provider Information
NPI: 1609195775
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEIGERT
FirstName: SARAH
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: R.M.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8725 WADSWORTH BLVD
Address2: UNIT A
City: WESTMINSTER
State: CO
PostalCode: 800030928
CountryCode: US
TelephoneNumber: 3034257298
FaxNumber: 3039408330
Practice Location
Address1: 6001 S WILLOW DR
Address2:  
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801115111
CountryCode: US
TelephoneNumber: 3034257298
FaxNumber: 3039408330
Other Information
ProviderEnumerationDate: 05/27/2010
LastUpdateDate: 05/27/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000X8812COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


Home